Abstract Background Medical care avoidance affects individuals’ health status. Previous studies on medical care avoidance have mainly focused on medical costs and people’s satisfaction with medical services. This study investigates whether an individual’s sense of policy alienation toward medical care policy (SPA-M) affects behavioral intention of medical care avoidance, and to what extent an intermediary variable—medical financial risk perception–mediates the relationship between SPA-M and medical care avoidance. Methods A cross-sectional survey was conducted involving 434 people aged 35–59 years from Wuhu, a city in China’s Anhui province. A moderated mediation model was constructed to investigate the research question and sex (biological: male and female) was used as a moderating variable between SPA-M and medical financial risk perception. Results We found that SPA-M significantly impacted medical care avoidance, and that medical financial risk perception played a complete mediating role in this relationship, while sex moderated the relationship between SPA-M and medical financial risk perception. Conclusion This study contributes to the literature by enhancing our understanding of the factors that influence behavioral intention regarding medical care avoidance, deepening our understanding of the role of SPA-M in medical care policy, and expanding the role of sex differences in the analysis of the relationship between SPA-M, medical financial risk perception, and medical care avoidance, offering implications for public and community health.
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